Jennifer Masson, a 25-year-old chronic asthmatic, suffered hypoxic brain damage following a severe asthma attack in 2002. She remained in around the clock care, catastrophically brain damaged, for many years until her eventual death in 2016. An action was brought by her estate alleging she would not have been injured had ambulance officers administered her with adrenaline promptly.
The State of Queensland was vicariously liable for the acts of its ambulance officers and owed an established duty of care to Ms Masson. The question at trial was whether the State had breached that duty of care. In particular, the issues for the Court were:
- In 2002, was adrenaline ordinarily the preferred drug to administer to asthmatics in extremis?
- Did Ms Masson’s condition render salbutamol a preferred or equally acceptable option to adrenaline?
- Was the non-administration of adrenaline at the time of the initial treatment contrary to the QAS asthma guideline?
On 21 July 2002, the QAS responded to a call for assistance to a residence in Cairns. On arrival, Ms Masson was in respiratory arrest due to a severe asthma attack. Officers were given a brief history of Ms Masson’s asthma, her requests to be taken to hospital and her collapse. Officers were not advised, and did not know, that Ms Masson’s previous attacks had been successfully treated with the administration of adrenaline. She was administered salbutamol with some effect. The two frontline drugs in the treatment of asthma attacks at the time were adrenaline and salbutamol. The plaintiff submitted that adrenaline should have been administered. The defendant contended that the administration of salbutamol was a reasonable response to the known circumstances at the time.
The Decision at Trial
In respect of the breach issues, the court determined that:
- It was clear from the expert evidence that adrenaline was regarded as preferable to salbutamol for administration to asthmatics in extremis.
- The plaintiff’s high heart rate and blood pressure, in the context of her overall condition, meant it was medically sound to prefer the administration of salbutamol to adrenaline during her initial treatment.
- The officers made a clinical assessment and decided not to administer adrenaline due to the risk of a serious adverse reaction to Ms Masson’s condition. The court determined this decision was a reasonable response to the plaintiff’s dire condition. It was concluded that the treatment administered did not fall below the standard of care to be observed by ambulance offers and was not contrary to the QAS guidelines. No breach of duty could be established and the claim failed.
Implications for you
Each case will turn on its circumstances. Here, the court took into consideration Ms Masson’s condition at presentation, the standard of care owed by the officers and even the medical knowledge available at the time.